I say we do, and I will point out a couple of really great and positive things that have happened. One thing I found in my research is that the Social Security Administration announced in March of this year that they will have an option for a third gender marker, the X, which designates Non-Binary or other gender identities that are not male or female. This option isn’t available right now due to the agency having to reconfigure their computer systems, but what is available now is something amazing. We can now self-select our M or F gender marker. This means Transgender and Non-Binary people no longer need to provide some kind of proof as to their legal/personal gender identity. In the past one had to provide proof of gender confirmation surgery, originally this meant a surgeon’s letter indicating genital surgery. This denied so many people the right to have their correct gender marker on so many legal documents.
For many Trans and Non-Binary people, having access to life affirming surgery is not possible due to financial reasons. Only recently have insurance companies started paying for our medical care, up to and including surgery. As awareness grew more and more, medical and psychological professionals agreed that health care for Trans and Non-Binary folks is indeed medically necessary. Only then did things begin to change for us. When the medical community came onboard to support us, other agencies began to fall in line as well. One of those being the Social Security Administration. Organizations such as the National Center for Transgender Equality, The Transgender Law Center and HRC fought hard to change the way our gender markers could be changed. Slowly more and more states approved gender marker changes to the birth certificates, state ID’s, and driver’s licenses. With some great legal minds, a letter was drafted that was vaguely worded but provided true attestation to a gender confirming surgery, instead of only being allowed to use full genital reconstruction to provide proof of gender change, this letter enabled anyone with any kind of gender surgery, for example top surgeries, orchiectomies, or facial feminization to obtain legal proof of your gender. Signed by your surgeon, this letter has been used for about the last 18 years. As time went on most states allowed for a name and gender change through a court order, and this letter was used for that as well. Presently, many states including California, allowed for self-identification on a legal gender change. This legal document could then be used at the Social Security Office to change the gender marker on your records. Other agencies across states and the federal government fell in line and things have been so much easier. It was never ok to have to show medical documentation to a Social Security Clerk about our private medical procedures. As a side note, if you do change your name and/or gender you do have to apply for a new Social Security card.
What about passports? According to the US State Department website, this agency has also been working to make changes to their systems. They are actually the first Federal government agency to allow us to self- select our gender marker without proof of medical or legal intervention, even if it doesn’t match other identity documents. In June 2021 the Secretary of State Antony J. Blinken announced this change along with the upcoming X marker as an option for gender. The X marker on Passports has been available since April of this year. Go State Department!
These are certainly huge things to be grateful for.
I have a very personal gratefulness I thought I would like to share. Today transitioning folks have in California, and many other states, fairly easy access to gender confirming surgeries. When I transitioned in 2003 there was no easy process. The gatekeeping for surgeries was very high back then. But often the biggest obstacle was the cost. There was no insurance coverage for any kind of surgery, so the only folks who were able to take that step were the ones who could afford it. I was not one of those people. I had my top surgery in 2005 and $7000 dollars was almost insurmountable for me. Thank goodness there were surgery loans of which I availed myself, since my dysphoria around my chest was excruciating. I was thrilled beyond measure after my surgery, only to be deeply saddened by the outcome. My surgeon was inexperienced and talked me into a different procedure from what I wanted. The results were terrible. Three years later, thanks to a very talented, kind and compassionate surgeon, I had my chest surgery completely redone and this time my joy knew no bounds. What an amazing feeling to walk in the world with at least some of your body matching your vision of yourself. By this time, I began to contemplate what we in the community call “bottom surgery”. For Trans-masculine people, this entails surgery on the existing genitalia to create a phallus. I knew a few folks who had the surgery, as they were financially able to afford not only the cost of the surgery, but also the extensive time off from work, and travel to the few surgeons we had at the time who could do these surgeries successfully.
I will admit, I was jealous and longed to have my own bottom surgery. I saw no way for that to happen. Aside from winning the lottery, which by the way I never did, I simply couldn’t even fathom coming up with the necessary amount. So, I put my hopes and dreams away on the shelf and convinced myself I neither wanted nor needed such gender confirming surgery. I did a very good job of that, as I had done numerous times throughout my life, when I saw no hope for the life I had always dreamed of. Trans and Non-binary people are, I think, excellent at dismissing our wants and needs when circumstances build against us, leaving very little hope of achieving even the simplest things sometimes. So there sat my bottom surgery hopes, on the shelf getting dustier and dustier with time. Who needed it anyways?
Then something amazing happened. In 2012 the California Insurance Board issued regulations called the Equal Access to Health Insurance: Coverage for Transgender Californians. That stopped insurance companies from discriminating against Transgender people to cover all transition related care, up to and including surgeries. These regulations would force insurance companies to comply with the California Insurance Non-Discrimination Act which was passed in 2005. I am so grateful I live in a state that holds up their promises to my community.
This is something I had never dreamt possible. There was of course still a very rocky road to go getting insurance companies on board, even though it was the law. Today we still fight for some insurance companies to comply with this law. So now I had access to surgery, wow! It awed me, and then, I dismissed it. I had so firmly embedded in my brain that surgical intervention would never truly be a reality for me, that I continued to deceive myself into thinking I didn’t want to do it. Then a funny thing happened on the way to my self- realization. I suddenly did want it and was creating a plan in my head to go and get it. Be all that you can be Connor!! But my life always had a way of circumventing my dreams. Beginning in the fall of 2014 I had a series of injuries that required extensive surgeries. Between 2015 up to April of 2021 I underwent 10 different operations. These events further impacted my mindset that bottom surgery would never become a reality for me.
Now here we are in 2022, it was early January when I really took a good look at what I wanted to be able to fulfil myself as a whole person. I had just turned 69 and who knew how much time I had left to undergo my final stages. A new voice entered my head and this time it said, “Why not? Why not me? Why can’t I do this?” So, I summoned up my courage and dialed the number for Kaiser Transgender Care. Within a few months I had my psychological clearance, then a consultation with the amazing team at Kaiser West LA Medical Center. This was really happening, and I was so excited!! A dream dismissed long ago was finally becoming a reality. I wanted my body to match who I am, I wanted to be whole while I had time to settle into my complete self before old age caught up with me. I didn’t want to be in a nursing home without a penis, LOL.
As I write this article, I am two days away from my surgery. I am not having the full on create a “giant penis” called Phalloplasty, (kidding about the “giant” penis, it’s usually 4-6 inches) which I once wanted, but due to my age and some medical conditions I have opted for one called the metoidioplasty, which uses the existing enlarged clitoris, a side effect of the Testosterone. They will reroute my urethra so that I can urinate from it, then they close the vaginal orifice, and create a scrotum. A male body at last and I am so incredibly grateful I have the means to achieve my final gender goal.
Never give up on your dreams, never say never to yourself for many things which seem to be beyond our reach, are one day possible.
Have a wonderful and safe Thanksgiving everyone.